Date   

Re: Updated Case History - New Hay Analysis

Kirsten Rasmussen
 

Hi Anne,

When you get your insulin/glucose back it will be very interesting to see what it is on that hay, which I assume you are feeding unsoaked(?).  The starch is quite high and unfortunately starch has a 2x greater effect on insulin than ESC.  So you may need to soak to reduce the ESC as much as possible in order to minimize the effect of the high starch, which does not soak out unfortunately.  But if her bloodwork comes back as Compensated IR then I would not think soaking is necessary as long as she is asymptomatic and her ACTH is controlled.

Sounds like you have a good plan.

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


Updated Case History - New Hay Analysis

anneefrancis@...
 

Hi there,

I just got the results for my hay.  I panicked when I first read the NSC # but then remembered that we look at ESC + Starch.   I have my current feed ration in my Case history file.  I'm waiting on Insulin/Glucose and Vit E test results.  Tricana was recently diagnosed with PPID, I've started her on .25 of Prascend, will increase to .5 this week then to 1 pill and will retest in December.   Aside from being a little buxom and cresty, she has no symptoms.    I'm planning on deep diving into balancing her feed but in the meantime is there anything glaring that I should be addressing?  She's also on Jiaogulan and AAKG to address her DSLD, which appears to be stable (knock on wood.)  

Best,

Anne

Anne & Tricana
May 2016

https://ecir.groups.io/g/CaseHistory/files/Anne%20and%20Tricana


Re: 2 months after initial laminitis episode

Eleanor Kellon, VMD
 

At one extreme, there's a level of pain that will drop any horse (or human). Beyond that, we have no way of  comparing the pain one horse experiences to another, especially as manifested in their behavior. It's not that simple. For example, the horse is a prey animal whose instinct is to run. Being down is a very vulnerable position. Depending on the individual's personality, they may chose to avoid that as long as possible while another may give in to it. They can't talk so we can't tell what they're thinking.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: 2 months after initial laminitis episode

Lorna Cane
 

I've always thought ,too, that some horses are leery of going down, fearing that they might not be able to get back up.
I don't know of any science to back up my suspicion.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Re: 2 months after initial laminitis episode

LJ Friedman
 

A question about laminitis, with the horses down, we know that’s not a bad thing. Protecting the feet etc. But when they’re down does that mean they’re in more pain than if they’re not down? I remember when jesse was laminitic  and he was walking like a cripple, pardon the pun, he never went down. Could it be Horse his personality? Or is down always more pain than not down but still walking in a lot of pain?
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: 2 months after initial laminitis episode

Kirsten Rasmussen
 

I think it will help when you get your markups back and a trim done, too, as running around on post-laminitic hooves with long toes could cause further pain/damage, which is a good possibility for why she is sore after.  She's obviously feeling good if she wants to run around, but not really thinking about her feet hurting her after until its too late (I think the adrenalin of running and playing can overshadow any pain at the moment, but then they do feel it after).  Your arena certainly looks like it has lots of soft sand, so I'm thinking its just the trim now and I know you are in the process of sorting that out...  For a now, can you make her turnout area a little smaller with panels?  As Sherry suggested, boots with pads might help too.

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


Re: nitro glycerine patch laminitis

Eleanor Kellon, VMD
 

Gilhooly also stated:

"Vascular damage during laminitis may decrease NO concentrations, rendering the vessels more responsive to NTG-induced vasodilation. Therefore, our results do not necessarily predict a negative vasodilatory effect of NTG in horses
with laminitis. In fact, in a study using grass-induced laminitis in ponies, Hinckley et al. demonstrated alleviation of bounding digital pulses and improvement of lameness with administration of topical NTG."
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Metformin and Magnesium

Eleanor Kellon, VMD
 

Carla,

Yes.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: nitro glycerine patch laminitis

Eleanor Kellon, VMD
 

Nitrate and nitroglycerin are not the same thing. Nitrate poisoning occurs when large amounts of nitrate are converted to nitrite which binds with hemoglobin and prevents oxygen binding. Nitroglycerin is a nitric oxide donor - same principle as supplementing with Jiaogulan to increase nitric oxide.

Nitroglycerin delivered directly into the blood supply does cause dilation of the hoof vessels. The failure of paste and patches in Gilhooly et al could have been for several reasons - dose, peculiarities of equine skin or strong counterregulatory actions in normal horses that counterbalanced it.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Metformin and Magnesium

Carla Anderson Peters
 

Hello,
I syringe Cupcake's Metformin to her, and I am wondering if I can add some magnesium without any complications?
Thank you!
--
Carla

 

December 2013, WI

Cupcake and Gunnar's Case Histories 

Cupcake's Photos

Gunnar's Photos 

Ω



Re: Help! My mare keeps getting cast in her run in!

Judy and Bugsy
 

There are also anti cast surcingles available. I don’t have any personal experience or know how well they work. Maybe others can chime in if they have tried it. 


https://www.brubachersharness.ca/contents/en-us/p76885_Brighton-Leather-Anti-Cast-Roller-Surcingle.html


--

 

Judy and Bugsy

Regina, Saskatchewan, Canada

Feb. 25, 2020

https://ecir.groups.io/g/CaseHistory/files/Judy%20and%20Bugsy
https://ecir.groups.io/g/CaseHistory/album?id=243358

 




Re: 2 months after initial laminitis episode

Cheryl Oickle
 

In my experience, I let my mare move at her own will in her paddock all the time she was in pain. If she was down , I provided her hay and water as close to her as possible.  Her paddock was about 200x200 so there was room for her to buck and run if she chose. Her run in had lots of bedding for her comfort.
IMO I have never heard of confining them during their acute processes as it can cause more issues.  Motion is lotion

--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel
https://ecir.groups.io/g/CaseHistory/album?id=81063


Re: nitro glycerine patch laminitis

Sherry Morse
 

LJ,

Found to be unsuccessful when studied: https://pubmed.ncbi.nlm.nih.gov/16343148/

Although in 1997 it was thought it might be a useful treatment: https://thehorse.com/14745/nitroglycerine-for-laminitis-use-caution/ and even at that time it was noted it should not be used on horses with endotoxemic episodes.




Re: Low nitrate hay, Santa Rosa?

 

Hi, Marija. You will receive an official welcome soon. I'm sorry to hear your horse has nitrate-induced laminitis. Since I'm located in Sonoma County, I'll try to answer your hay question. The only hay seller with tested hay is  Larsen's Feed, and the only tested hay is their low carb hay. I don't buy it because I don't like the quality.  My experience has been that later in the cutting season, by the third cut and all winter, locally available hays can have high to dangerously high nitrates. After I figured that out, I have arranged to buy an entire year's supply of hay in late August to early September, when I can buy second cut hay. The carbs aren't as low as third cut, but the nitrates tend to be lower. Dave's Hay Barn is closed. Frizelle Enos and Rivertown source the same hay because of common ownership. 

I do my own hay testing in cooperation with another member here. This year we found low nitrate hay from Western Farm Center. You're welcome to join our hay testing group. You can send me a private message, and I will give you more details. I'm finished for the year, but my partner, who can only store 50 bales as a time, will be searching for low carb, low nitrate hay soon enough. 

Do you know that you can reduce nitrates in hay by soaking the hay? 

--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 


Re: Low nitrate hay, Santa Rosa?

 

Hello Marija,
Here is a link to an article written by Dr. Kellon about Nitrates. https://ecir.groups.io/g/main/files/5%20Core%20Diet/1.%20Hay%20Information/Nitrate%20Guidelines%202012.pdf
You can also search for additional info about Nitrates by using the Search boxes that you will find on each page. You can search for the term within the messages here in the Main Group or you can click on the Files category (see in column on left) and type Nitrates in the search box at the top of the Files page. 

You will be getting responses from moderators and members who have dealt with Nitrate Poisoning. If you have specific questions you can add additional posts/questions to this first post which moves this message back to the top of the message list.

All new members receive a detailed new member post that we ask you to read thoroughly. All of the sections relate to each other. Diagnosis is a starting point but Diet is critical to what you can do immediately for your horse. Diet affects the hooves. Hooves of a laminitic horse usually require a change in Trimming.

The Main Group Wiki is your best tool to learning the HOW-TO use this group, move around, create folders, upload photos, etc. Before you tackle something new like adding a link to your case history folder you should refer to the WIKI and the GETTING AROUND THE ECIR section. It will save you time!

One more suggestion for you about your signature. If you narrow down your actual location in your signature, like adding what county you live in, you get more responses from ECIR members who live near you. This can be helpful when you are trying to find safe feeds and hay or a good trimmer.

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: IR is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you. 

 

--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


nitro glycerine patch laminitis

LJ Friedman
 

I read a previous thread about nitrate induced laminitis. I’ve never heard of such a thing and when I did a search I read that you can use a nitroglycerin patches to help laminitis? Sounds crazy to me? Correct?
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Low nitrate hay, Santa Rosa?

mlvulfs
 


I am a new member still working on my new member profile to upload for my horse. I have a 26 year old gelding who has nitrate induced laminitis. Any suggestions for a low carb/low nitrate hay source? The ones I know of who sometimes have hay tests and sometimes I need to test myself are:

Frizelle Enos
Larsen's Feed
Scarpete Hay
Dave's Hay Barn
Western Farm Center
Rivertown Hay and Feed
North Bay Hay and Grain
--
Marija Vulfs, N. California, 2020


Re: Surpass vs Voltaren

Sherry Morse
 

Hi Helen,

Same here as far as I was putting it on an area that had been clipped for an ultrasound.  When I was using the low intensity ultrasound (different issue) that also required keeping the area clipped to help with the treatment but that particular injury didn't need Surpass so I can't say if it would have helped or not.




Re: Surpass vs Voltaren

Helen Connor
 

Sorry, that should have read, "I'm thinking of trimming..." I talk pretty someday.
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847


Re: Surpass vs Voltaren

Helen Connor
 

Sherry, that clipping comment is interesting. I wondered if that would make a difference. Blessing is growing out her clip from the ultrasound right now. I'm thought of trimming it back to help absorption. She's wearing a blanket already, so I'm not worried about exposure of the skin in that limited area.
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847

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